Most practicum students worry about their ability to do or say something intelligent in their counseling sessions. Will we have something to say? Will we know what to do? In order to know where to intervene, it may be helpful to think about various points in the counselee’s life that may need intervention–and then consider which point to choose and what kinds of interventions would be most helpful.
To help set the stage, I’ve constructed a few slides :
1. Every client constructs and maintains a sense of self and a sense of the world. A number of factors influenced that sense of self, some of which I’ve listed here:
2. We shape and reshape that sense of self through experiences and interpretations that either reinforce or reconstruct/challenge our sense of the world and self:
3. The counselor may wish to intervene in several places. (1) Stop and start behaviors; encouraging environmental changes; mercy ministries, (2) Challenging interpretations, Encouraging a change in what is attended to (mindfulness), and (3) Reflecting back on the sense of self and world (uncovering core beliefs and experiences). Note 2 things however. First, none of these points of intervention will be of much value if there isn’t a working relationship that enables the client to trust the counselor enough to be vulnerable. Second, choosing a point of intervention is important but equally important is the kind of intervention (open or closed questions, reflections of content or feeling, advice/information, summarizing, confrontation, etc.)
Musings on Faith and Psychology 
I think knowing “why” to intervene must precede “when, where, how” issues. If my goal as a counselor is guided by an overarching purpose of helping my client feel better fast and eliminate presenting problems, I’m going to respond much more differently than I would if my purpose is to cultivate an opportunity for character growth. When my “whys” are in biblical consonance, I seem to have a more comfortable time with the rest. I work in a field where the pressure is incredible to “fix kids fast” and move them out the door to make room for the next kid. “Fake it ’til you make it” and other “problem fixing” strategies abound…and conflict with my biblical bent to address problematic character issues that are obviously (to me) at the core of the behavioral problem…and sometimes I choose interventions and timing that reflect more of my industry than my training, and that bothers me at times.